The proposed research will identify those factors which distinguish between those who use the services of public health departments and those who prefer similar services from private physicians. Attention will focus on three sub-groups: rural dwellers, urban welfare recipients, and marginally-disadvantaged urban dwellers. A key issue will be the effect of money cost, time cost, convenience cost, and cost in lost intimacy as these differentiate those who seek preventive and ambulatory services from public health departments vs. private physicians. The assumption here is that with the enactment of National Health Insurance, cost as a factor affecting health care utilization will be replaced in importance by issues such as time, convenience, and intimacy. Thus, current consumer behavior with regard to public health services may be predictive of future consumer behavior under NHI. These objectives will be accomplished by analyzing existing survey interview data which have been collected from 511 users of public health services and 400 non-users in four counties in Illinois, each of which has an urban center and a rural area. Analysis of variance and regression analyses will be performed to determine those factors and their weightings which affect utilization. When these factors are isolated 100 in-depth interviews will be conducted to triangulate (validate) results. The final report will examine the effect of these non-financial cost factors and project the effect of NHI on rural, welfare, and marginally-disadvantaged groups.